The Effects of Short-Term Food Deprivation on Caloric Intake in Eating-Disordered Subjects

The primary aim of this experimental investigation was to examine the effects of short-term dietary restriction on caloric consumption in eating disordered subjects. Subjects with bulimia nervosa, binge eating disorder, and overweight non-eating disordered subjects, attended a laboratory experiment during which they were randomly assigned to either a 1 h or a 6 h food deprivation condition prior to being served a multi-item buffet. The primary measure of interest was calories consumed during the laboratory experiment. Subjects deprived of food for 6 h consumed significantly more calories at the buffet compared to subjects in the 1 h food deprivation condition. However, caloric intake during the entire laboratory day was not affected by the experimental manipulation. Subjects in the longer deprivation condition apparently compensated at the buffet for the caloric restriction, but did not overcompensate.     

What Do International Pharmacoeconomic Guidelines Say about Economic Data Transferability?

ObjectivesThe objectives of this article were to assess the positions of the various national pharmacoeconomic guidelines on the transferability (or lack of transferability) of clinical and economic data and to review the methods suggested in the guidelines for addressing issues of transferability.MethodsA review of existing national pharmacoeconomic guidelines was conducted to assess recommendations on the transferability of clinical and economic data, whether there are important differences between countries, and whether common methodologies have been suggested to address key transferability issues. Pharmacoeconomic guidelines were initially identified through the ISPOR Web site. In addition, those national guidelines not included in the ISPOR Web site, but known to us, were also considered.ResultsAcross 27 sets of guidelines, baseline risk and unit costs were uniformly considered to be of low transferability, while treatment effect was classified as highly transferable. Results were more variable for resource use and utilities, which were considered to have low transferability in 63% and 45% of cases, respectively. There were some differences between older and more recent guidelines in the treatment of transferability issues.ConclusionsA growing number of jurisdictions are using guidelines for the economic evaluation of pharmaceuticals. The recommendations in existing guidelines regarding the transferability of clinical and economic data are quite diverse. There is a case for standardization in dealing with transferability issues. One important step would be to update guidelines more frequently.     

Slower Eating Speed Lowers Energy Intake in Normal-Weight but not Overweight/Obese Subjects

BackgroundThe effect of eating speed on energy intake by weight status is unclear.ObjectiveTo examine whether the effect of eating speed on energy intake is the same in normal-weight and overweight/obese subjects.DesignThe effect of slow and fast eating speed on meal energy intake was assessed in a randomized crossover design.Participants/settingThirty-five normal-weight (aged 33.3±12.5 years; 14 women and 21 men) subjects and 35 overweight/obese (44.1±13.0 years; 22 women and 13 men) subjects were studied on 2 days during lunch in a metabolic kitchen.InterventionThe subjects consumed the same meal, ad libitum, but at different speeds during the two eating conditions. The weight and energy content of the food consumed was assessed. Perceived hunger and fullness were assessed at specific times using visual analog scales.Statistical analysesEffect of eating speed on ad libitum energy intake, eating rate (energy intake/meal duration), energy density (energy intake per gram of food and water consumed), and satiety were assessed by mixed-model repeated measures analysis.ResultsMeal energy intake was significantly lower in the normal-weight (804.5±438.9 vs 892.6±330.2 kcal; P=0.04) but not the overweight/obese (667.3±304.1 vs 724.8±355.5 kcal; P=0.18) subjects during the slow vs the fast eating condition. Both groups had lower meal energy density (P=0.005 and P=0.001, respectively) and eating rate (P<0.0001 in both groups) during the slow vs the fast eating condition. Both groups reported less hunger (P=0.01 and P=0.03, respectively), and the normal-weight subjects reported more fullness (P=0.02) at 60 minutes after the meal began during the slow compared with the fast eating condition. There was no eating speed by weight status interaction for any of the variables.ConclusionsEating slowly significantly lowered meal energy intake in the normal-weight but not in the overweight/obese group. It lowered eating rate and energy density in both groups. Eating slowly led to lower hunger ratings in both groups and increased fullness ratings in the normal-weight group at 60 minutes from when the meal began.     

What patients know about their rights in Turkey

Patients' rights issues are currently being discussed in health care at both the private and public levels in Turkey. In this study, 317 patients were interviewed upon hospital discharge and asked what they knew about their "rights" as patients. According to the collected data, 63% of the patients were not aware that they had any rights in receiving health care services at all. Since this is the first study of its type in Turkey, further research in this area is needed. In closing, it is recommended that hospitals in Turkey adapt routine policies similar to those in the United States for informing customers about their rights for safe, effective and efficient health care provision.     

Assessment of Dietary Intake Using Food Photography and Video Recording in Free-Living Young Adults: A Comparative Study

BackgroundConventional methods of dietary assessment are prone to recall bias and place burden on participants.ObjectiveOur aim was to compare the performance of image-based dietary assessment (IBDA), including food photography (FP) and video recording (VR), with the criterion of weighed food records (WFR).DesignIn this comparative study, participants captured meals using FP and VR before and after consumption, over 2 days. Food type and portion size were assessed using the images and videos. Energy and nutrient intakes (mean of 2 days) were compared against WFR.Participants/settingsEighty-four healthy adults (mean [standard deviation] age = 29 [8] years), recruited through advertisement in Glasgow, UK, between January and August 2016 were enrolled in the study. Eighty participants (95%) (mean [standard deviation] age = 28 [7] years) completed the study and were included in the analysis.Main outcome measuresAgreement in estimated energy and nutrient intake between WFR and IBDA. The IBDA method feasibility was evaluated using a questionnaire. Inter-rater and intra-rater reliability were assessed.Statistical analysis performedThe performance of the IBDA methods against WFR and their inter and intra-rater reliability were tested with Bland-Altman plots and Spearman correlations. Intra-class agreement between methods was assessed using κ statistics.ResultsInter-rater reliability was strong for both IBDA methods in estimating energy intake (ρ-coefficients: FP = 0.80; VR = 0.81). There was no difference in the agreement between the 2 assessors. Intra-rater reliability was high. FP and VR underestimated energy intake by a mean (95% agreement limits) of –13.3% (–56.4% and 29.7%) and –4.5% (–45.5% and 36.4%), respectively. IBDA demonstrated moderate-to-strong correlations in nutrient intake ranking, median ρ-coefficients for all nutrients: FP = 0.73 (interquartile range, 0.09) and VR = 0.82 (interquartile range, 0.02). Inter-class agreement of IBDA methods was moderate compared with the WFR in energy intake estimation. IBDA was more practical and enjoyable than WFR.ConclusionsIBDA and VR in particular demonstrated a moderate-to-strong ability to rank participants’ dietary intake, and considerable group and inter-class agreement compared with the WFR. However, IBDA was found to be unsuitable for assessment in individuals.     

What children's stories tell us about their understanding of illness

Twenty five-year-olds and twenty eight-year-olds were asked to tell six stories on health and illness-related themes. Analysis of the stories did not support a stage-theory of developmental changes in understanding of illness. It is argued that young children share many ideas about illness with older children, but these may be limited by the very restricted nature of experience.     

Palatability of a Meal Influences Release of Beta-Endorphin, and of Potential Regulators of Food Intake in Healthy Human Subjects

The effect of the palatability of a meal was tested on the post-prandial release of several gut hormones or neuropeptides which are known to have an effect on intake and satiety. Hormonal response was determined in plasma during the 3 h after a highly palatable and energy-rich meal or after the same meal served cold in a poorly acceptable form, as well as while fasting. The early post-prandial pancreatic polypeptide and neurotensin response was significantly higher after the highly palatable meal than after the cold one. Later responses differed only for pancreatic polypeptide. No difference was observed in cholecystokinin and neutropeptide Y levels. Post-prandial levels of beta-endorphin were elevated only after the cold meal and were associated with an elevated response of ACTH.We suggest that beta-endorphin might be secreted in response to an aversion towards the non-palatable cold meal. This could, subsequently, inhibit the cephalic phase of pancreatic polypeptide response and the early post-prandial response of neurotensin by a central anticholinergic effect. This study evidences an effect of palatability on the modulation of the digestive hormonal response after a meal.     

What can musicians’ claims data reveal about their musculoskeletal conditions?

Abstract

Musculoskeletal (MSK) symptoms are common amongst professional musicians. No study has reported on workers’ compensation claims (WCCs) of musicians to determine the proportion of claims and costs attributed to MSK conditions. We analyzed Australian WCCs for professional musicians 2004/2005–2015/2016. MSK conditions accounted for 69.78% of claims; 50.46% of which were for upper limb conditions. MSK conditions also accounted for 77.76% of costs for musicians’ WCC. The most common reported mechanism for MSK claims was body stressing (72.48%), and the most common agency was “other non-powered equipment” (including musical instruments; 39.71%), which also accounted for 51.27% of upper limb claims specifically. For the first time, we showed that MSK conditions account for the majority of musicians’ WCC, and the majority of the cost of claims, making them the biggest health issue for professional musicians.     

What people really know about their health insurance: a comparison of information obtained from individuals and their insurers

OBJECTIVES: This study determined the validity of self-reported data on selected health insurance characteristics. METHODS: We obtained telephone survey data on the presence of health insurance, source of insurance, length of time insured, and type of insurance (managed care or fee-for-service) from a random sample of 351 adults in 3 Wisconsin counties and compared findings with data from respondents' health insurers. RESULTS: More than 97% of the respondents correctly reported that they were currently insured. For source of insurance among persons aged 18 to 64 years, sensitivity was high for those covered through private health insurance (93.8%) but low for those covered through public insurance (6.7%). Only 33.1% of the respondents accurately categorized length of enrollment in their current plan. Overall estimates for managed care enrollment were similar for the 2 sources, but individual validity was low: 84.2% of those in fee-for-service believed that they were in managed care. CONCLUSIONS: Information obtained from the general population about whether they have health insurance is valid, but self-reported data on source of insurance, length of time insured, and type of insurance are suspect and should be used cautiously.     

Diet Quality of Frequent Fast-Food Consumers on a Non-Fast Food Intake Day Is Similar to a Day with Fast Food,What We Eat in America,NHANES 2013-2016

BackgroundFrequent fast food (FF) consumers may make more healthful food choices at eating occasions without FF. However, it is not clear if poor diet quality of frequent FF consumers is a function of FF consumption or less healthful food choices overall.ObjectiveThe objective of this study was to compare diet quality, energy, and nutrient intakes of infrequent FF consumers (INFREQ) with that of frequent FF consumers on an intake day with FF (FREQ-FF) or without FF (FREQ_NO FF).DesignThis study is a cross-sectional analysis of 1 day dietary intake data from What We Eat in America, National Health and Nutrition Examination Survey 2013-2016, the dietary intake component of National Health and Nutrition Examination Survey.Participants/settingParticipants included adults aged 20 years and older (N = 4,012), who, during the previous 7 days, reported no consumption of FF or pizza (n = 2,142 INFREQ) or reported FF or pizza three or more times and either had FF/pizza (n = 1,455 FREQ_FF) or did not have FF/pizza (n = 415 FREQ_NO FF) on the intake day.Main outcome measuresMain outcomes were energy, nutrient density (nutrient intake per 1,000 kcal), and diet quality evaluated using Healthy Eating Index (HEI) 2015.Statistical analyses performedGroup comparisons were made using t tests. Differences were considered significant at P < 0.001.ResultsCompared with INFREQ consumers, FREQ_FF consumers had higher intakes of energy and fat per 1,000 kcal, lower scores for total HEI and most components, and lower nutrient densities of most micronutrients (P < 0.001). HEI component scores of INFREQ consumers for vegetables, fruit, whole grains, and added sugars were higher than FREQ_FF consumers (P < 0.001). Energy intake, most nutrient densities, and total HEI and component scores of FREQ_NO FF consumers were not significantly different from FREQ_FF consumers with the exception of fruit but were different from INFREQ consumers for some nutrients and HEI components.ConclusionsResults suggest diet quality and nutrient intake of frequent FF consumers on a non-FF intake day is not markedly different from a day with FF.     

What children know about their birth circumstances in stepfamily adoption in the Republic of Ireland

The majority of adoptions of children born in the Republic of Ireland nowadays relate to children in stepfamilies. The children involved in these adoptions are the children of the natural mother and they have no blood relationship to the mother's husband. They are children of a previous non-marriage relationship as children of marriage or divorce are not eligible for stepfamily adoption. The child is adopted into the stepfamily to allow her/him equal legal status to other children of the marriage. Some children in adopting stepfamilies have no/inadequate information about their origins, despite world recognition of a child's right to knowledge of their identity and birth parents. This paper outlines the numbers of children in this situation, and the growing openness over time to allowing children such information. It explores the relevance of social work intervention in such cases. The research was carried out in 2002, on 269 confidential Adoption Board files, for a Masters thesis in social work.     

Food exemplar salience. What foods do people think of when you tell them to change their diet?

Understanding which specific foods easily come to mind when individuals consider categories of dietary behavior may help explain observed patterns of dietary intake. We examined which specific behavioral exemplars are most easily retrieved from memory when individuals consider broad dietary categories. Participants reported specific foods that come to mind when considering high fat foods, low fat foods, and fruits/vegetables. Salient foods differed from those suggested in dietary guidelines, were distinct from those known to be major diet components, and showed a non-trivial number of incorrect responses. These findings have implications for understanding how individuals respond to dietary guidelines and devising effective intervention strategies.     

The INTER-ACT E-Health Supported Lifestyle Intervention Improves Postpartum Food Intake and Eating Behavior,but Not Physical Activity and Sedentary Behavior—A Randomized Controlled Trial

Unhealthy postpartum lifestyle is related to long-term adverse psychological, metabolic and cardiovascular health outcomes as well as to complications in the next pregnancy. Especially women with preceding excessive gestational weight gain are at risk. This paper aims to evaluate the effect of the postpartum phase of the INTER-ACT randomized controlled trial (RCT) on food intake, eating behavior, physical activity and sedentary time at the end of the intervention (six months postpartum) and at six-months follow-up (12 months postpartum). The study population comprised women with excessive gestational weight gain in the preceding pregnancy. The lifestyle intervention combined a smartphone application with four face-to-face coaching sessions between six weeks and six months postpartum. After the intervention, restrained eating score was 1 point higher (95% CI 0.5, 1.5; p < 0.001), uncontrolled eating score was 1 point lower (95% CI −1.9, −0.2; p = 0.02) and energy intake was 69 kcal lower (95% CI −123, −15; p = 0.01) in the intervention group compared to the control group. The differences were no longer statistically significant at follow-up. No significant effects on emotional eating, physical activity and sedentary behavior were found. In conclusion, the postpartum phase of the INTER-ACT RCT was effective in improving nutrition-related outcomes, however, these improvements could not be sustained at follow-up. ClinicalTrials.gov identifier: {"type":"clinical-trial","attrs":{"text":"NCT02989142","term_id":"NCT02989142"}}NCT02989142.